In A Treatise of Human Nature, Hume (1711-1776) said
‘When I enter most intimately into what I call myself, I always stumble on some particular perception or other, of heat or cold, light or shade…I never catch myself at anytime without a perception, and never can observe anything but the perception. When my perceptions are remov’d for any time, as by sound sleep; so long am I insensible of myself, and may be truly be said not to exist’
In this text, Hume claims that the self eludes us bar when we perceive and hence the self is no more than the sum of our perceptions. Furthermore, that
‘the rest of mankind…are nothing but a bundle or collection of different perceptions’
‘The mind is a kind of theatre, where several perceptions successively make their appearance…There is properly no simplicity in it at one time, nor identity…There are the successive perceptions only, that constitute the mind; nor have we the most distant notion of the place, where these scenes are represented, or of the materials of which it is composed’.
Hume challenges our natural assumptions about the self, namely that it has unity (simplicity in Hume’s terms), and that there is a singular identity over time. Even though Hume did not discuss the sense of agency, and our awareness of distinction from the world external to us these also are aspects of the self. For Hume and some contemporary philosophers such as Parfit and German Berrios, the self is a concept, not a thing. So the strong and urgent sense that one has of being embodied, and capable of grasping the material world by hand and manipulating it, and the feeling of being distinct and separate from others, that is of being unique, are all illusory.
Yet, in psychopathology there are cases that reveal that these notions are not mere concepts but lived and experienced. The pathologies that undermine the security of these assumptions demonstrate that the unity, identity, separateness and feeling of activity are intrinsic to how the self is structured.
Passivity experiences in schizophrenia, that is the experience of corrupted agency wherein the subject believes that he is no longer the author of his own actions but is under the control of external powers or authorities, signal that there are mechanisms, materially instantiated mechanisms, for our ‘owning’ our actions. That these mechanisms can go awry so that commonplace and ordinary actions such as swinging one’s arms, speaking, even breathing can come to seem alien. The precise mechanism need not be elucidated for there to be certainty that pathology is revealing something deep about the nature of agency, of volition and authorship. The most troubling of these passivity experiences are the so called made actions. See Daniel Schreber (1842-1911)
‘My nerves are influenced by the rays to vibrate corresponding to certain human words; their choice therefore is not subject to my will, but is due to an influence exerted on me from without. From the beginning the system of not-finishing- a-sentence prevailed, that is to say the vibrations caused in my nerves and the words so produced not mainly finished thoughts, but unfinished ideas or only fragments of ideas, which my nerves have to supplement to make up the sense’.
Singular identity over time is vouchsafed by the fact of our inhabiting one body. But, is it? Yet, rarely there are cases where the individual subject believes that he has been radically altered. Although he inhabits the same body yet his identity is different. And, what is important is that these are experiences and not merely the metaphorical use of language.
Finally, the unity of the self is itself undermined by such rare conditions as autoscopy and multiple personality disorder, in which there is fragmentation of the self into constituent parts. The best described of the multiple personality disorders is that by Morton Prince:
‘Miss Christine L Beauchamp, the subject of this study, is a person in whom several personalities have become developed; that is to say, she may change personality from time to time, often from hour to hour, and with each change her character becomes transformed and her memories altered. in addition to the real, original or normal self, the self that was born and which she was intended by nature to be, she may be anyone of …three persons’
The configuration of the self evolves out of the fact that we find ourselves in this material world. We come up against the physicality of it. It resists us and in this encounter we come to know that we are material beings with boundaries. In apprehending this material world with our limbs we come to recognize that we can manipulate the world, and that it is within our grasp, at least to a degree. Agency and willfulness derive from this. We also to come to know that there are other beings in the world. That these beings have projects of their own, that they can be unreliable and can frustrate our will. That is, that there are living beings who are independent of us. These basic ideas about the nature of the world rely on memory and categorization, and if that is what concepts are, then yes, the self is a concept. But, it is a concept drawn on structure.
My theme is travel. Travel, travelling, making a journey is often a metaphor for the journey of life. The great narratives, Homer’s Odyssey & Virgil’s Aeneid are both about journeys. In the Odyssey, Ulysses returns to Ithaca after the Trojan War & it takes 30 years to do so. His trials and his successes are symbolic of life’s trials and tribulations. In the Aeneid, the starting point is also the end of the Trojan War but this time it is the founding of the Roman Empire that results from Aeneas’ travels. Why is travelling and narratives about travel compelling? We are after all nomadic, migratory animals. Since our departure from the East African plains 150,000years ago, we have populated the earth and even now continue to travel. The fact of settlement in large cities, what we now call megalopolis, is a superficial cover for the irresistible desire to travel. Otherwise, there would be no Europeans in America or Australia, or indeed no Africans as modern Homo Sapiens all over the world. And the travel narrative harks back to this primordial nomadic urge and the interest in travel narratives satisfies this desire either to travel oneself or vicariously to do so.
I travelled among unknown men,
In lands beyond the sea;
Nor England! Did I know till then
What love I bore to thee
In travelling and meeting foreign peoples we can come to know who we are and also come to know and appreciate our own cultures. The expatriate English in Zimbabwe are more English than your average Englishman in Devon as are expatriate Indians or Nigerians across the world. Distance seems to accentuate the need to crystallise culture, to freeze it in time. My thesis is that there is much in common between the reports of travellers about the strange customs, appearance and behaviour of foreigners and the strange land of psychiatry. It is not accidental that psychiatrists were once referred to as alienists, a term that emphasises the perceived alien quality of psychiatric patients.
Let me start from Herodotus in his reference to Egyptians. By the time that he travelled in Memphis & Thebes, the Pyramids were already 2-3,000 years old. He said
About Egypt I shall have a great deal more to relate because of the number of remarkable things which the country contains, and because monuments which beggar description are to be found there than anywhere else in the world. The Egyptians seem to have reversed the ordinary practices of mankind. For instance, women attend market and are employed in trade, while men stay at home and do the weaving, Men in Egypt carry loads on their heads, women on their shoulders; [and Lord Almighty] women pass water standing up, men sitting down. To ease themselves they go indoors, but eat outside in the streets, on the theory that what is unseemly but necessary should be done in private, and what is not unseemly should be done openly
You can see that Herodotus, in describing another culture can only do so in comparison to what he is familiar with. In other words, descriptions always have a viewpoint and it is the departure from the usual, the familiar, and the supposed norm that attracts attention. As Edward Said would have said, in defining the Other we define ourselves. This is of course the case with psychopathology. It is the fact that thinking and perceptual disorders such delusions and hallucinations stand apart from what is usual, i.e.,are alien, that initiates our attention and interest and for the lay public, signals deviance and lays the groundwork for stigma and discrimination.
In travel writing, there is also, the fantastic, the impossible: This is yet still Herodotus describing what it is like south of Libya:
and here live the Garamantes, a very numerous tribe of people, who spread soil over the salt to sow their seed in..and it is among them that the cattle are found which walk backwards as they graze….The Garamantes hunt the Ethiopian hole-men, or troglodytes, in four-horse chariots, for these troglodytes are exceedingly swift of foot – more so than any people of whom we have information. They eat snakes and lizards and other reptiles and speak a language like no other, but squeak like bats. Ten days from the Garamantes is yet another hill and spring – this time the home of Atarantes, the only people in the world, so far as our knowledge goes, to do without names. Atarantes is the collective name – but individually they have none
Herodotus’ account of the Garamantes and Atarantes exemplifies the problem that social or cultural distance poses to clinical work. For Herodotus, social and cultural distance made anything south of Libya mysterious, fantastic or monstrous. The same is true of clinical practice. We meet this problem in many guises. See Falconer’s On horseback through Nigeria which opens
No one who is not quite callous to his fortune returns to Nigeria without feeling in full force of Touchstone’s argument. Those happy sunny days at home press upon one’s heart; in vain one thinks of busy cities and sweet companionship, of green fields and leafy lanes – those dank mangrove swamps are all too real! And beyond is a land of darkness, of sickness, of discomfort, of trial: the land where life at best is but existence, where one lives in the past and in the future, least of all in the present!’ And ‘Forcados should always be visited by night, for by day it is a dismal place. A few houses built on a spit of mud and mangrove-roots accommodate the Resident, the doctor, the Customs officer, and the Company’s agent. The native population consists of a dozen or so amphibious creatures, who inhabit a few waterlogged huts half-hidden amongst the mangroves and eke out a precarious existence upon the produce of their fishing nets
The emphasis is on the words ‘amphibious creatures’, that is less than human primarily because of their social distance from Falconer. What I am arguing is that the same sensitivity that ensures that we do not see any other human being in these terms, whether alien to our culture or not, also ensures that we treat patients irrespective of any abnormality of mind, as persons deserving respect, attention and proper concern.
Communal sexual displays are colourful, dramatic and spectacular. These displays occur in a lek or arena and in the true leks of birds, for example in the sage grouse, each lek contains a mating centre and up to 400 male birds congregate in the lek visited by a comparable number of females for short periods to be mated. The male displays are extraordinary: the male inflates his chest sac, struts with its head held high. The white feathers and thin plumes at the side of neck are erected and the combs over the eyes are expanded. As its wings are expanded and moved forwards and backwards, making a swishing sound, the bird emits an arresting call. All of this to display and attract females for mating!
These displays are communal and hence large numbers of males are involved simultaneously and supposedly the females are able to identify the fittest males and to submit to them. The male traits on display are the signals that the females use to assess male quality. Peacocks also form leks to display their tails. These traits to be useful for females must somehow be a true sign of health and fitness. There are a number of biological issues that require solutions such as the lek paradox but these are not the subject of this post.
It is always instructive to think whether social behaviours in the animal world have any parallels in the human world. This is the value of ethology to psychiatry, the willingness to explore and investigate what we know about animal behavior in order to garner better understanding of human behavior.
The closest we have to communal display in the human is probably the extraordinary and colourful annual Charm Dance ritual of the Woodaabe, (Woodaabe Geerewol) a nomadic people on the fringes of the Sahara Desert. This is a weeklong ceremony dominated by three dances: the Ruume a daytime dance of welcome and nighttime dance of seduction; the Yaake, a competitive dance; and the Geerewol, in which young men are judged for their beauty and elegance. The valued traits are height and the whites of the eyes. It is clear that elaborately staged communal displays are rare in modern human society. But it is possible that fragments of these elaborate displays continue in an attenuated form and in unregulated informal settings. These fragments may be reduced in scale and complexity but yet retain the same primary purpose of signaling sexual fitness.
Not long ago in Hawaii I witnessed on a windy day when it rained hard and all day how only the courageous and adventurous, mainly men, surfed the waves, ceaselessly. Wading and paddling against the tide and then riding the crest of the wave back in, chivalrous and handsome against the feeble light, skilfully borrowing the waves’ energy and speed before keeling over, limp and spent. This was repeated without break all day. Crowds gathered to marvel, to capture the moment in photo or simply to enjoy the sight of mastery and courage. Two boys dazzled with their youth and confidence towards the end of the day. Slim and urgently fragile, they surfed and skied, sheer for speed and indifferent to the severally ardent observers, they remained focused, industrious in their drive to rule the crest of the wave for as long as possible. What was the purpose of their daring, their persistence, their doggedness?
At the end of the day, at the very stand where the crowds came to admire the dexterity of the surfers, a young attractive blond, slim and sure of herself and her beauty, posed next to a spotlight so that it shone on her blond locks, her carefully made up face, her irresistibly long and false eyelashes. She was a princess, a rare and sexually intense beauty, everything about her shone a lustre that is unforgettable, that asked forcefully to be noticed and worshipped. Her mother took the photos, once and the daughter checked to see the effect, twice and the daughter checked once again. One more for luck, can I be even more beautiful, shine even brighter, be more golden, more a rare gem, an orchid even, that draws all the light to itself, that is fragrant and tender, that expects to conquer the world simply with its colour and a smile.
These displays, fragments of the communal lek displays can be seen if sought out. On beaches, on high streets, at athletics meetings, football stadia, principally at nightclubs, preening and showing off the traits and phenotypes that might be judged as signals of fitness, the sexually desirable characteristics one might search for in potential mates as evidence of health and ultimately of fecundity.
In Euripides’ Medea, Medea says
O Zeus! Why have you given us signs to tell
True gold from counterfeit; but when we need to know
Bad men from good, the flesh bears no revealing mark?
Evidently the fidelity of the traits on display as true signals of fitness is questionable.
In ‘Funes the Memorious’ Jorge Luis Borges (1899-1986) wrote about Ireneo Funes whose memory was prodigious. Funes had been ‘chronometrical’, (that is he was able to know the exact time without the aid of a clock) before an accident in which he was thrown by a half-tamed horse and paralysed. After the accident he became Funes the Memorious. Funes’ feats included knowing ‘by heart the forms of the southern clouds at dawn on 30 April 1882’ and being able to ‘compare them in his memory with the mottled streaks on a book in Spanish binding he had only seen once and with the outlines of the foam raised by an oar in the Rio Negro the night before the Quebracho uprising’. Borges goes on ‘In fact, Funes remembered not only every leaf of every tree of every wood, but also the times he had perceived or imagined it’. Because of his hypermnesia, Funes ‘was incapable of ideas of a general Platonic sort. Not only was it difficult for him to comprehend that the generic symbol dog embraced so many unlike individuals of diverse size and form; it bothered him that the dog at three fourteen (seen from the side) should have the same name as the dog at three fifteen (seen from the front)’.
Borges in his usual playful manner is in this story exploring the extent to which memory aids or obstructs our capacity to think, to create categories, to understand underlying and organizing principles within our perceptual world. What would a life be like, if memory was as prodigious as Funes’? Would there be a need to classify objects in the world? The clutter of excessive detail, the inexhaustible capacity for remembering, would of course, in this argument that Borges is examining, render higher level reasoning problematic, to say the least. Once we are unable to remember every object as unique the requirement to classify and to attribute class membership to new objects develops. Now, I am interested in this line of reasoning because it demonstrates the place of memory in abstraction, in theory formation, in the business of beliefs, of expectations, of speculation, approximation, and model making.
Memory allows us to manipulate the objective world in the abstract, in the absence of the objective world. I can conjure up my memory of a beautiful woman, adorn her ears with glittering jewelry if I so choose, make her give me an enchanting smile, and so on. This freedom to redefine the world, to categorize it, to predict it, to approximate it by modeling it in mind is the basis of much that helps us to survive the world we live in.
There are a number of real life cases of hypermnesia but Funes was a fictional case. Borges, in this story, was borrowing from the method of psychopathology. He was using an aberrant or pathological experience to understand the nature of cognition, even in the absence of definable neurological lesions. Borges was working from first principles.